The role of genetic variation in observed racial differences in heart failure morbidity and mortality are unknown. Clinical trial data suggests that African Americans with heart failure may benefit from a combination of hydralazine/isosorbide dinitrate previously thought to be ineffective in all populations. This discovery has led to the development of a hydralazine/isosorbide dinitrate combination, which may be approved for use exclusively in African Americans with heart failure. Physicians' perceptions on race and genetic variation and patient trust are likely to influence the implementation of any race-based therapies. While African Americans often place less trust in physicians, the underlying factors associated with racial differences in trust have not been fully elucidated. To determine the factors underlying racial differences in patient trust and to explore the use of race as a proxy for genetic variation in the treatment of heart failure, the applicant proposes a two-phase study. Phase I uses quantitative methods to analyze survey data on patient trust among African Americans and Caucasians. Phase II uses focus groups to explore physicians' perceptions of use of race as a proxy for genetic variation in the treatment of heart failure. [unreadable] [unreadable]